Open Access

Primary headaches and painful spontaneous cervical artery dissection

  • Cynthia R. Campos1, 2, 3,
  • Marcelo Calderaro3,
  • Milberto Scaff3 and
  • Adriana B. Conforto3
The Journal of Headache and Pain20078:387

https://doi.org/10.1007/s10194-007-0387-6

Published: 11 June 2007

Abstract

The relation between primary headaches (PH) and pain related to spontaneous cervical artery dissection (SCAD) is still unclear, as well as the progress of PH after dissection. To investigate this relation, the characteristics of pain related to SCAD and changes in PH patterns after SCAD, we evaluated 54 consecutive patients. Thirty-five (65%) had previous PH. Painful SCAD occurred in 39 (72%). Frontal and parietal localizations were significantly associated with internal carotid artery dissection (p=0.013 and p=0.010, respectively), whereas occipital and nuchal pain, with vertebral artery dissection (p=0.047 and p<0.001, respectively). Previous PH did not influence the presence of pain at SCAD onset. Twenty-six (74%) patients with PH reported improvement in PH pattern after a mean follow-up of 32 months. These results suggest that mechanisms underlying PH do not modulate dissection-related pain. Disruption of perivascular afferents may be involved in improvement of PH patterns after SCAD.

Keywords

Artery dissection Carotid Vertebral artery Primary headaches Migraine Stroke